Brian J White, R Presley Swann, Hannah Spears, Anna Shafer, Shannon M Constantinides
{"title":"失败的髋关节唇部重建可以成功地修正为另一个唇部重建:在至少2年的随访中改善了患者报告的结果。","authors":"Brian J White, R Presley Swann, Hannah Spears, Anna Shafer, Shannon M Constantinides","doi":"10.1093/jhps/hnae033","DOIUrl":null,"url":null,"abstract":"<p><p>The purpose of this study was to validate the success of revision arthroscopic circumferential allograft labral reconstruction (CLR) in nonarthritic hips, which, in the rare case of failure, had previously undergone labral reconstruction by the same surgeon. Using a minimum of 24-month follow-up, data from 24 hips having undergone revision CLR were analyzed to determine improvements in patient-reported outcomes (PROs). All included cases completed a minimum of 24 months follow-up, with a success rate of 96%. All PROs improved significantly, with exceptionally strong measures of effect. Modified Harris Hip Scores improved by a mean of 26.68 points, with 88% of patients meeting the minimal clinically important difference (MCID) (+6.49, <i>P</i> ≤ .001, <i>d</i> = 1.32). Lower Extremity Functional Scale scores improved by a mean of 21.88 points, with 78% of patients meeting the MCID (+7.79, <i>P</i> ≤ .001, <i>d</i> = 1.32). Pain as rated by the Visual Analog Scale, including at rest, during activities of daily living, and with sports, was significantly improved with strong measures of effect, with >75% of patients having met the MCID. This study validated that a failed labral reconstruction of the hip can be revised safely and effectively to another labral reconstruction of the hip. While labral reconstruction has broadly been shown to result in highly favorable outcomes, this study demonstrated that in the rare case of failure, revision CLR is not only feasible but results in improved pain and functionality.</p>","PeriodicalId":48583,"journal":{"name":"Journal of Hip Preservation Surgery","volume":"11 4","pages":"271-279"},"PeriodicalIF":1.4000,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11744474/pdf/","citationCount":"0","resultStr":"{\"title\":\"Failed labral reconstruction of the hip can be successfully revised to another labral reconstruction: improved patient-reported outcomes at a minimum of 2-year follow-up.\",\"authors\":\"Brian J White, R Presley Swann, Hannah Spears, Anna Shafer, Shannon M Constantinides\",\"doi\":\"10.1093/jhps/hnae033\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>The purpose of this study was to validate the success of revision arthroscopic circumferential allograft labral reconstruction (CLR) in nonarthritic hips, which, in the rare case of failure, had previously undergone labral reconstruction by the same surgeon. Using a minimum of 24-month follow-up, data from 24 hips having undergone revision CLR were analyzed to determine improvements in patient-reported outcomes (PROs). All included cases completed a minimum of 24 months follow-up, with a success rate of 96%. All PROs improved significantly, with exceptionally strong measures of effect. Modified Harris Hip Scores improved by a mean of 26.68 points, with 88% of patients meeting the minimal clinically important difference (MCID) (+6.49, <i>P</i> ≤ .001, <i>d</i> = 1.32). Lower Extremity Functional Scale scores improved by a mean of 21.88 points, with 78% of patients meeting the MCID (+7.79, <i>P</i> ≤ .001, <i>d</i> = 1.32). Pain as rated by the Visual Analog Scale, including at rest, during activities of daily living, and with sports, was significantly improved with strong measures of effect, with >75% of patients having met the MCID. This study validated that a failed labral reconstruction of the hip can be revised safely and effectively to another labral reconstruction of the hip. While labral reconstruction has broadly been shown to result in highly favorable outcomes, this study demonstrated that in the rare case of failure, revision CLR is not only feasible but results in improved pain and functionality.</p>\",\"PeriodicalId\":48583,\"journal\":{\"name\":\"Journal of Hip Preservation Surgery\",\"volume\":\"11 4\",\"pages\":\"271-279\"},\"PeriodicalIF\":1.4000,\"publicationDate\":\"2024-10-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11744474/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Hip Preservation Surgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1093/jhps/hnae033\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/12/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q3\",\"JCRName\":\"ORTHOPEDICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Hip Preservation Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1093/jhps/hnae033","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/12/1 0:00:00","PubModel":"eCollection","JCR":"Q3","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
引用次数: 0
摘要
本研究的目的是验证翻修关节镜下环缘同种异体唇瓣重建术(CLR)在非关节炎髋关节中的成功,在罕见的失败情况下,以前曾由同一外科医生进行过唇瓣重建术。通过至少24个月的随访,分析了24个髋关节的翻修CLR数据,以确定患者报告的预后(PROs)的改善。所有纳入的病例完成了至少24个月的随访,成功率为96%。所有的PROs都有了显著的改善,效果非常明显。改良Harris髋关节评分平均提高26.68分,88%的患者达到最小临床重要差异(MCID) (+6.49, P≤)。001, d = 1.32)。下肢功能量表评分平均提高21.88分,78%的患者达到MCID (+7.79, P≤)。001, d = 1.32)。根据视觉模拟量表(Visual analogue Scale)评定的疼痛,包括休息、日常生活活动和运动时的疼痛,都得到了显著改善,效果显著,约75%的患者达到了MCID。本研究证实,失败的髋关节唇部重建可以安全有效地进行另一次髋关节唇部重建。虽然唇部重建已广泛显示出非常好的结果,但本研究表明,在极少数失败的情况下,翻修CLR不仅可行,而且可以改善疼痛和功能。
Failed labral reconstruction of the hip can be successfully revised to another labral reconstruction: improved patient-reported outcomes at a minimum of 2-year follow-up.
The purpose of this study was to validate the success of revision arthroscopic circumferential allograft labral reconstruction (CLR) in nonarthritic hips, which, in the rare case of failure, had previously undergone labral reconstruction by the same surgeon. Using a minimum of 24-month follow-up, data from 24 hips having undergone revision CLR were analyzed to determine improvements in patient-reported outcomes (PROs). All included cases completed a minimum of 24 months follow-up, with a success rate of 96%. All PROs improved significantly, with exceptionally strong measures of effect. Modified Harris Hip Scores improved by a mean of 26.68 points, with 88% of patients meeting the minimal clinically important difference (MCID) (+6.49, P ≤ .001, d = 1.32). Lower Extremity Functional Scale scores improved by a mean of 21.88 points, with 78% of patients meeting the MCID (+7.79, P ≤ .001, d = 1.32). Pain as rated by the Visual Analog Scale, including at rest, during activities of daily living, and with sports, was significantly improved with strong measures of effect, with >75% of patients having met the MCID. This study validated that a failed labral reconstruction of the hip can be revised safely and effectively to another labral reconstruction of the hip. While labral reconstruction has broadly been shown to result in highly favorable outcomes, this study demonstrated that in the rare case of failure, revision CLR is not only feasible but results in improved pain and functionality.